Can stress cause hemorrhoids? Understanding the connection and tips for relief

If you’ve experienced hemorrhoids, you may have noticed something frustrating: symptoms sometimes flare when you’re feeling stressed.  

“When people are stressed, their bodies hold onto more tension,” says Karina Marquez, PT, DPT, a pelvic floor physical therapist at Hinge Health. “That tension can affect digestion, bowel habits, and pelvic floor muscles — all of which can affect hemorrhoid symptoms.”

But you don’t have to just deal with hemorrhoids. “If you notice hemorrhoids appear when you’re stressed, engaging in regular movement, breathing exercises, and practicing healthy bathroom habits can make a big difference,” says Dr. Marquez.

Here’s what to know about the connection between stress and hemorrhoids — and what you can do to break the cycle, including soothing exercises recommended by Hinge Health pelvic floor physical therapists.

The connection between stress and hemorrhoids

Stress doesn’t directly cause hemorrhoids. But it can influence several body systems that affect digestion and bowel movements.

When you're stressed, your nervous system shifts into a heightened alert state, known as “fight or flight.” In the short term, this response can slow digestion and change how your gut functions.

“Your brain and digestive system are closely connected,” says Dr. Marquez. “When stress is high, people may notice changes in appetite, hydration, sleep, or physical activity — all of which can affect your bowel habits and routines.”

For example, during stressful periods, people may:

• Drink less water

• Eat fewer fiber-rich foods

• Move their bodies less

• Have sleep disruptions

All of these factors can contribute to constipation. When stool becomes harder to pass, people may strain while sitting on the toilet, which increases pressure on the veins around the anus and can worsen hemorrhoids.

Causes of hemorrhoids

Hemorrhoids can happen to anyone. They develop when pressure builds in the veins around the rectum and anus, such as when sitting for long bouts of time and eating a low-fiber diet. Common factors that can contribute to that pressure include: 

• Prolonged sitting and straining during bowel movements. Spending long periods sitting — especially on the toilet — can increase pressure on rectal veins. “When people are constipated, they sometimes sit and strain for longer periods, which can aggravate hemorrhoids,” says Dr. Marquez. Constipation can also make you feel like you need to push harder during bowel movements. This increases pressure on the veins in the rectal area, which can cause them to swell, says Dr. Marquez.

• Eating a low-fiber diet. Fiber helps soften and bulk stool, making bowel movements easier to pass. Without enough fiber, stools may become harder and more difficult to move through the digestive tract.

• Age-related changes. Your body is resilient, but certain age-related changes can make you more susceptible to hemorrhoids. “As you get older, the tissue around your rectum and anus weakens, which puts more pressure on those veins,” says Dr. Marquez. 

• Pregnancy and childbirth. During pregnancy, the growing uterus places pressure on pelvic veins, which can increase the likelihood of hemorrhoids. Hormonal changes can also slow digestion, making constipation more common. During labor, pushing can place additional strain on rectal veins, which may cause hemorrhoids to develop or flare.

• Heavy lifting. Lifting heavy weights is beneficial for your long-term health. But, if you increase weight too quickly, before your body is prepared to lift that heavy, it can potentially lead to hemorrhoids. “Lifting heavy weights increases pressure inside the abdomen, which can place strain on pelvic veins,” says Dr. Marquez. “Holding your breath while lifting can also increase pressure in your abdomen, increasing the risk of hemorrhoids.” 

• Digestive conditions. Conditions like irritable bowel syndrome (IBS) are often amplified by stress and can cause either frequent constipation or diarrhea. “Both can irritate the rectal area and contribute to hemorrhoids,” says Dr. Marquez.

Symptoms of hemorrhoids

Symptoms depend on what type of hemorrhoid you have. If you have external hemorrhoids, which form under the skin around your anus, you may notice:

• Itching or irritation

• Swelling or a small lump near the anus

• Discomfort or pain when sitting

Internal hemorrhoids, on the other hand, develop inside the rectum. They’re often painless but they can cause bleeding during bowel movements, often appearing as bright red blood on toilet paper or in the toilet.

Note: Because rectal bleeding can have other causes, it’s important to talk to your healthcare provider if you notice blood in your stool.

How movement can help prevent hemorrhoids

Regular exercise helps your digestive system operate smoothly and normally, by promoting healthy bowel movements. “Movement in general increases blood flow and circulation, which in turn helps to increase how quickly food gets digested,” says Dr. Marquez. It also helps to ease tension in your hip and pelvic floor muscles, which in turn will make going to the bathroom even easier. Think about it: tight pelvic floor muscles can make it more challenging to pass stool. 

Movement also helps to reduce stress. “It calms your nervous system and lowers your cortisol, or stress, levels,” says Dr. Marquez. Activities that activate the mind-body connection including yoga, Tai Chi, or deep breathing, can be especially helpful because they address both digestion and stress at the same time. “Relaxing exercises like these ones can also reduce abdominal pressure that worsens hemorrhoids,” says Dr. Marquez.

These targeted exercises help reduce tension in the pelvis, hips, and lower back all while supporting healthy digestion. Breathing exercises calm the nervous system and regulate abdominal pressure, while stretching and mobility movements help relax muscles that influence bowel movements.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for hemorrhoids

Regular movement can help manage and treat hemorrhoids — especially when combined with physical therapy and targeted exercises. It’s also important to drink plenty of fluids and use over-the-counter treatments when necessary. Here’s what Hinge Health physical therapists recommend:

• Try pelvic floor physical therapy and targeted exercises. Targeted exercises, like the ones above, can release tension from your pelvic floor muscles, which can help remove pressure from veins and nerves in your rectal region. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a pelvic floor physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Stay active. Targeted exercises are designed to help with recovery, but any type of movement — like walking, stretching, or even household chores — can help get things moving and loosen tense muscles. “Physical activity supports healthy digestion, which can reduce the likelihood of constipation and straining during a bowel movement,” says Dr. Marquez.

• Consider over-the-counter hemorrhoid treatments. There are topical over-the-counter options to treat your hemorrhoids. Phenylephrine ointment (Preparation H) shrinks hemorrhoids and may temporarily relieve itching. Witch hazel (Tucks, Preparation H pads or wipes) will dry and tighten the skin around your anus. You can also try a hydrocortisone rectal cream like Preparation H hydrocortisone (just don’t use it for more than a week). Be sure to consult your healthcare provider about these treatments before starting them, especially if you’re pregnant.

• Stay hydrated. Drinking enough fluids helps prevent constipation, which can contribute to hemorrhoids. In general, men need about 13 cups of fluids per day, while women need about nine. (But everyone is different — you may need more if you’re very physically active or pregnant.)

• Practice stress relieving techniques. This might include deep breathing, yoga, meditation, or even light physical activity like going for a walk. “It’s whatever works for you to regulate your nervous system,” says Dr. Marquez. Another relaxing option is a warm sitz bath, where you soak your rectal area in warm water for 10 to 15 minutes. (You can find sitz baths at most drugstores.) This can increase blood flow to the area and help relax the anal muscles, which may relieve hemorrhoid discomfort.

• Prioritize nutrition. Eating a balanced, nutrient-rich diet supports your body’s natural healing processes. Focus on foods like fruits, vegetables, fatty fish, nuts, seeds, and whole grains. These foods help reduce inflammation and offer nutrients that support tissue repair, such as omega-3 fatty acids and vitamins C and D. For individualized guidance, consider working with a registered dietitian. 

• Consider complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for stress relief, such as massage, acupuncture, or chiropractic care.

How to prevent hemorrhoids 

Sometimes, hemorrhoids pop up out of nowhere, meaning you can’t always prevent them. But, adopting healthy daily habits can help lower your risk of developing them. Regular movement, a consistent bathroom routine, and getting enough rest all support healthy digestion and reduce straining. These approaches include:

• Take movement snacks throughout the day. “When you sit for long periods of time, blood can pool in the rectal veins and slow the healing of hemorrhoids,” says Dr. Marquez. If you sit at a desk for work most of the day, consider getting up to move around and walk or stretch every so often. 

• Eat a high fiber diet. Fiber helps soften stool and make it easier to pass, which can reduce straining during bowel movements and lower your risk of hemorrhoids. The Dietary Guidelines for Americans recommend getting about 14 grams of fiber for every 1,000 calories you eat. For most adults, that shakes out to roughly 25 to 35 grams of fiber per day.

• Establish a consistent bathroom routine. Try to have a bowel movement at the same time each day, since your bowels tend to respond well to routine and predictability, says Dr. Marquez. Many people naturally feel the urge to go after a meal. You may also want to place a small stool beneath your feet (sometimes called a “squatty potty”) to help position your body in a way that makes bowel movements easier to pass. Try to limit toilet time to less than 10 minutes. “The more you sit and strain, the more pressure you put on hemorrhoids,” explains Dr. Marquez.

• Don’t delay bowel movements. If you feel the urge to go, try not to wait. “If you hold it in, the muscles around your anus, rectum, and pelvic floor can tense up, which increases pressure on the veins,” says Dr. Marquez.

• Practice good sleep hygiene. Sleep plays an important role in managing stress and supporting overall health, which can help reduce hemorrhoid flare-ups, says Dr. Marquez. Get better sleep by practicing sleep hygiene habits, such as cooling your bedroom or listening to calming music before bedtime.

When to see a doctor

Most hemorrhoids resolve on their own with simple, at-home treatments. But if your hemorrhoids are severe, getting worse, or causing difficulty with daily activities, see a healthcare provider. It’s also a good idea to get care if you have persistent bleeding or a lump that doesn’t shrink.

PT tip: Take a short walk after meals

Taking a walk after mealtime can help support your mind and body, and in turn, your bowel movements. “Going for a five-to-10-minute walk after eating can help stimulate digestion and reduce stress,” says Dr. Marquez. Small, consistent movements like this have a bigger impact than you might expect.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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3. Taylor, D. C., Xu, Y., Kosch, K. J., Liang, Y., Tran, P. T., Simrén, M., & Chey, W. D. (2023). S656 Burden of Anal/Rectal-Related Adverse Consequences Associated with Chronic Straining Among Patients with Irritable Bowel Syndrome And/Or Constipation. Official Journal of the American College of Gastroenterology | ACG, 118(10S), S479. doi:10.14309/01.ajg.0000952264.64660.94

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